<div class="panel panel-info">
	<div class="panel-heading">{{'PrestationType.CAPITAL' | translate}}</div>
	<div class="panel-body">
		<div class="form-group">
			<label class="col-sm-2 control-label" translate="SinisterInfo.debitEffectiveExcess"></label>
			<div class="col-sm-3">
				<input type="text" ng-model="sinister.sinisterInfo.debitEffectiveExcess" amount>
			</div>
			<label class="col-sm-2 col-sm-offset-1 control-label" translate="SinisterInfo.fundingAmount"></label>
			<div class="col-sm-3">
				<input type="text" ng-model="sinister.sinisterInfo.fundingAmount" amount>
			</div>
		</div>
		<div class="form-group">
			<label class="col-sm-2 control-label" translate="SinisterInfo.estimatedAmount"></label>
			<div class="col-sm-3">
				<input type="text" ng-model="sinister.sinisterInfo.estimatedAmount" amount>
			</div>
		</div>
	</div>
</div>